Procedural outcomes of laparoscopic caudate lobe resection: A systematic review and meta-analysis

Abstract

A systematic review was conducted in compliance with PRISMA statement standards to identify all studies reporting outcomes of laparoscopic resection of benign or malignant lesions located in caudate lobe of liver. Pooled outcome data were calculated using random-effects models. A total of 196 patients from 12 studies were included. Mean operative time, volume of intraoperative blood loss, and length of hospital stay were 225 minutes (95% confidence interval [CI], 181-269 minutes), 134 mL (95% CI, 85-184 mL), and 7 days (95% CI, 5-9 days), respectively. The pooled risk of need for intraoperative transfusion was 2% (95% CI, 0%-5%). It was 3% (95% CI, 1%-6%) for conversion to open surgery, 6% (95% CI, 0%-19%) for need for intra-abdominal drain, 1% (95% CI, 0%-3%) for postoperative mortality, 2% (95% CI, 0%-4%) for biliary leakage, 2% (95% CI, 0%-4%) for intra-abdominal abscess, 1% (95% CI, 0%-4%) for biliary stenosis, 1% (95% CI, 0%-3%) for postoperative bleeding, 1% (95% CI, 0%-4%) for pancreatic fistula, 2% (95% CI, 1%-5%) for pulmonary complications, 1% (95% CI, 0%-4%) for paralytic ileus, and 1% (95% CI, 0%-4%) for need for reoperation. Although the available evidence is limited, the findings of the current study might be utilized for hypothesis synthesis in future studies. They can be used to inform surgeons and patients about estimated risks of perioperative complications until a higher level of evidence is available.

Keywords: Caudate lobe; Hepatectomy; Laparoscopy; Liver resection.

Fig. 1

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart.

Fig. 2

Outcomes of methodological quality assessment of included studies using the Joanna Briggs Institute (JBI) Critical Appraisal tool for case-series.

Fig. 3

Forest plots and Doi plots for: (A) need for intraoperative transfusion; (B) conversion to open surgery; (C) need for intra-abdominal drain; (D) postoperative mortality; (E) biliary leakage; (F) intra-abdominal abscess; (G) biliary stenosis; (H) postoperative bleeding; (I) pancreatic fistula; (J) pulmonary complications; (K) paralytic ileus; and (L) need for reoperation.